INDIVIDUAL ENTHESEAL POINTS HAVE DIFFERENTIAL FREQUENCY OF INVOLVEMENT AND IMPACT ON PATIENT REPORTED OUTCOMES IN PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS: POOLED ANALYSIS OF TWO PHASE 3, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDIES
Authors: Coates L et al.
The location of enthesitis in PsA may impact patient reported outcomes (PRO). A posthoc analysis was performed that used pooled data from two guselkumab trials including 473 PsA patients with active disease despite standard therapies and baseline enthesitis, DISCOVER-1 and DISCOVER-2, who received guselkumab 100mg sc every 4 weeks or at baseline, week 4, week 8 and then every 8 weeks. 49.5% of all guselkumab patients had a baseline enthesitis LEI score of 1 or 2. The Achilles tendon was most frequently involved. Over 52 weeks, higher baseline LEI scores were associated with increased patient pain and patient global assessment and HAQ-DI scores. The analysis of individual entheseal points revealed that the Achilles tendon involvement had the greatest impact on all PROs, in contrast, the medial femoral condyle had the least impact. Median time to resolution was 8 weeks on guselkumab treatment for each of the three anatomical sites (Achilles tendon, medial femoral condyle, lateral humeral epicondyle) assessed by the LEI.
This analysis is the first that addresses the impact of a specific location of an enthesitis on PRO such as pain and HAQ-DI. The results show that the enthesitis of the Achilles tendon insertion is most important. This finding may have implications for daily practice to guide decision making.